Register for a Course

How registration works

Submit this form, and Agrecia will reply by email within one working day to confirm date availability and send payment instructions. Your booking is only confirmed once payment is received. As soon as we receive payment, your pre-course manual is sent for pre-reading.

01 Course Selection

Course*

Preferred date*

02 Your Details

First name*

Last name*

ID / Passport number*

Profession*

HPCSA registration number

Employer / Practice

03 Contact Information

Email address*

Mobile / phone*

Postal address

04 Prerequisite Certification

Most ACLS, PALS, AMLS and NRP courses require a valid AHA BLS Provider Certificate as a prerequisite. If this applies to your course, please supply your existing cert details.

Existing certificate number

Certificate expiry date

Upload a copy of your certificate (PDF or image) Optional. Max 10 MB. PDF, JPG or PNG.

05 Additional Information

Dietary requirements

How did you hear about us?

Notes / special requests

06 Consent I confirm that the information above is accurate. I understand that my registration is only confirmed on receipt of payment, that course materials will be sent for pre-reading once payment is received, and that AALS may contact me by email or phone in relation to this registration.*

Required fields are marked with *

Thank you — we’ve received your registration